title: Diabetes self-management behaviors and A1c improved following a community-based intervention in older adults in Georgia senior centers.
abstract: A community-based intervention to improve diabetes self-management (DSM) and decrease A1c in older adults with diabetes from Georgia senior centers was evaluated. Participants were a convenience sample that completed the pre-test questionnaire only (N = 351) and a subset that completed the pre-test, intervention, and post-test questionnaires and A1c measurements (n = 144, mean age = 74 years, 84% female, 42% white, 57% black). Incorporating principles of the Health Belief Model and National Standards for DSM, the 4-month intervention consisted of eight sessions focused on improving daily adherence to DSM behaviors and included physical activity. At the post-test, several DSM behaviors increased by > or = 1 day/week: following a healthy eating plan, following an eating plan prescribed by their doctor, eating five or more servings of fruits and vegetables daily, spacing carbohydrates, and inspecting the insides of shoes (P < or = 0.0001). The mean decrease in A1c for the entire sample was 0.25% (SD = 0.82, P < or = 0.001, n = 144) and those with an initial A1c > 8% had a clinically significant mean decrease of 1.15% (SD = 1.09, pre-test: 9.48% vs. 8.33%, P < or = 0.001, n = 24). Increased physical activity was the DSM behavior consistently associated with decreased A1c in regression analyses (P < or = 0.05). The results of this evaluation provide an evidence base for the effectiveness of this community intervention in decreasing A1c and improving DSM behaviors in older adults.
authors.affiliation: Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Speer
authors.forename: Sudha
authors.initials: S
authors.lastname: Reddy
authors.forename: Tiffany Sellers
authors.initials: TS
authors.lastname: Lommel
authors.forename: Joan G
authors.initials: JG
authors.lastname: Fischer
authors.forename: Stephens
authors.initials: S
authors.lastname: Heather
authors.forename: Sohyun
authors.initials: S
authors.lastname: Park
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Johnson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000097:blood / Q000178:diet therapy / Q000628:therapy*; D004032:Diet / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005845:Georgia; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006442:Glycated Hemoglobin / Q000032:analysis*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015596:Nutrition Assessment; D010349:Patient Compliance / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods* / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012648:Self Care / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D006442:Glycated Hemoglobin